CMS Price Transparency Data

Ultrasound, pelvis

Facility: Union Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $104
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Union Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $441 (413%)
Insurance Median: $104 (97%)
Cash: $441 (413% of Medicare)
Ins. Median: $104 (97% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Summacare $20 - $683 19%
Aetna $31 - $976 29%
Blue Cross Blue Shield $31 - $362 29%
Cigna $31 - $306 29%
Humana $31 - $98 29%
The Health Plan $31 - $584 29%
United $31 - $335 29%
Valor $31 - $98 29%
Aultcare $32 - $306 30%
Communicare $32 - $103 30%
Mmo $32 - $683 30%
Perennial Health $33 - $106 31%
Pphp $33 - $108 31%
Cc Ehp $34 - $507 32%
Zing Health $34 - $108 32%
Buckeye $72 - $132 67%
Molina $72 - $138 67%
Caresource $75 - $132 70%
Amerihealth $79 - $145 74%
Oscar $79 - $261 74%
UnitedHealthcare $95 - $98 89%
Devoted Health $98 92%
Upmc $98 - $586 92%
Ohcp $116 - $380 109%
Omas $148 - $488 139%
Healthsmart $163 - $537 153%
Phphi $178 - $586 167%
Gms $208 - $683 195%
Consociate Health $223 - $732 209%
Multiplan $267 - $878 250%
Amish Community Aid Plan $306 - $340 286%
Ohio Healthy $367 344%
Php $407 381%
Medical Benefit Corp $475 445%
Frontpath $611 572%
Managed Care Services $611 572%
Tertiary Care Network $611 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals